Presutto Elizabeth, Chappell Matthew, Fullmer Joseph, Ezhapilli Sajeev
SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA.
Department of Radiology, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
Radiol Case Rep. 2018 Feb 3;13(2):365-370. doi: 10.1016/j.radcr.2018.01.007. eCollection 2018 Apr.
Medulloblastoma is the most common posterior fossa tumor of childhood typically within the fourth ventricle. However, extra-axial medulloblastoma in posterior fossa is an uncommon diagnosis. We report a case in a 33-month-old male who presented with repeated complaints of abdominal pain, intermittent emesis, and diarrhea, and diagnosed with right cerebellar extra-axial medulloblastoma, which was surgically resected. Majority of the reported extra-axial medulloblastoma in posterior fossa in the United States are located in the cerebellopontine angle. However, to the best of our knowledge, our case is the first to document medulloblastoma occurring exclusively in the cerebellar hemispheric extra-axial space rather than the cerebellopontine angle. Although the diagnosis can present as a radiological dilemma, a systematic multimodality imaging approach can aid in narrowing the differential diagnosis and timely management. In this case report, we will discuss the imaging characteristics, differential diagnosis, and management strategies, alongside a brief review of the world literature of extra-axial medulloblastoma.
髓母细胞瘤是儿童期最常见的后颅窝肿瘤,通常位于第四脑室内。然而,后颅窝轴外髓母细胞瘤是一种罕见的诊断。我们报告一例33个月大男性病例,该患儿反复出现腹痛、间歇性呕吐和腹泻症状,被诊断为右侧小脑轴外髓母细胞瘤,并接受了手术切除。在美国报道的大多数后颅窝轴外髓母细胞瘤位于小脑脑桥角。然而,据我们所知,我们的病例是首例记录到的仅发生在小脑半球轴外间隙而非小脑脑桥角的髓母细胞瘤。尽管该诊断在影像学上可能存在难题,但系统的多模态成像方法有助于缩小鉴别诊断范围并及时进行治疗。在本病例报告中,我们将讨论其影像学特征、鉴别诊断和治疗策略,并简要回顾轴外髓母细胞瘤的世界文献。